It is important that parents understand that a child’s foot is not just a miniature adult foot. Kids’ feet are still developing. Relatively soft cartilage is present and bone is still forming. Especially during the first year of your child’s life, their feet will be incredibly soft and pliable. This means that any abnormal, repetitive pressures (form a poorly fit shoe for example) can easily cause the foot to deform. The rules that you have learned about taking care of their own feet often do not translate to what is best for your children.
What are the Ideal Conditions for Your Kids’ Feet?
Children’s feet develop best when they are barefoot. Many studies show that walking barefoot early in life actually helps feet develop properly and aids in proper growth of the muscles. By giving the toes freedom to move and “grasp”, the feet naturally develop strength and coordination.
It isn’t always practical, however, to go barefoot all of the time. When walking or rough floors or outside you need to protect babies’ feet. Their soft, tender skin needs protection from the dangers of infection through accidental cuts and abrasion. This is when proper footwear becomes very important.
Proper Footwear for Pre-walkers, Beginning Walkers and Toddlers
When choosing shoes for babies, beginning walkers and toddlers, studies have clearly demonstrated that shoes should have the following qualities:
|• Lightweight||The shoes should not be heavy or impede the child’s movement in any way.|
|• Flexible/Soft||The shoes should not restrict important toe and foot mobility, nor should they bind the growing feet in any way.|
|• Breathable||Constructed of breathable natural materials, such as leather, to promote healthy conditions around the feet.|
|• Flat||The shoes should not have any arch support. They should simulate barefoot conditions. This is critical. Many parents believe that because they require arch support, their kids do too. Except in the situation where a child has a “pathologically flat foot” or is overweight (see below) there should be NO arch support in your kids’ shoes. Arch support hinders the ability of a child’s foot to strengthen naturally.|
|• Smooth||The sole should be smooth (like the palm of your hand) to avoid catching on the ground. Avoid rubber soles.|
|• No heel||Avoid heels. Shoes should be flat.|
But my child has a flat foot, shouldn’t he/she have an arch support?
ALL children have flat feet at first. Kids’ feet start out flat and develop a normal arch by age 7. If you think your child may have an arch that is flatter than normal, and may be having problems because of it, have him or her checked out by your podiatrist or pediatrician. Arch support – whether built into the shoe or a separate device – is not recommended for most children
Do kids ever require arch support in their shoes?
First, if you think your child may need arch support, see a podiatrist or pediatrician. Do not make the decision on your own to use arch supports in your child’s shoes. In most cases, arch supports are not beneficial for children. There are, however, three situations where studies have shown that the use of arch supports or orthotics has been shown to be beneficial to children:
- Pathologic Flat Foot: Children who have arches which are flatter than they should be and who also have symptoms due the flat arch will often benefit from arch support and more stable shoes. Symptoms may include foot pain, leg pain, knee pain; or changes in the foot such as bunion formation. If you think your child might have feet that are flatter than normal, see a podiatrist or pediatrician. If you are in the Seattle area, make an appointment for your child to see us.
- Overweight: A number of studies have shown that if a child is carrying more weight than they should, the excess weight can harm the developing foot. Children who are overweight or obese often benefit from the use of arch supports and more stable shoes.
- Medical Conditions: In the presence of musculoskeletal or neurologic conditions (such as cerebral palsy, musculodystrophy, Down Syndrome, etc) orthotic devices are often beneficial.
General Rules on Choosing Children’s Shoes
- Children’s feet grow in spurts and require new shoes every 3 to 4 months.
- Avoid synthetics as they do not stretch and pressure from the shoe can harm a child’s feet.
- Kids’ feet sweat a lot, so the top of the shoe should be made of a breathable material, like leather or canvas.
- Children should not wear hand me down shoes. As most shoes mold to the foot, wearing hand me downs can apply abnormal force to the feet
- Shoes should be comfortable from the start. If new shoes need to be “broken in,” it means either they were not properly designed or not properly fitted for your child’s foot.
Children’s Shoe Stores in Seattle
We recommend that you use children’s specialty shoe stores when you purchase shoes for your child – if they are available. It is best to have your child fit by those who are experienced in fitting children’s shoes. In Seattle, unfortunately, there are currently no specialty shoe stores for children that we know of.
We recommend Super Jock and Jill for older kids. Their employees are well trained and they have a large selection of great shoes. If you own or know of other children’s’ shoe stores in the Seattle area, we would be happy to evaluate them.
Be sure to take the brochure with you to the shoe store next time your kids need shoes. Click here to download.
- Powell M. Efficacy of custom foot orthotics in improving pain and functional status in children with juvenile idiopathic arthritis: a randomized trial. J Rheumatol. 2005 May;32(5):943-50.
- Klein C. Increased hallux angle in children and its association with insufficient length of footwear: a community based cross-sectional study. BMC Musculoskelet Disord. 2009 Dec 17;10:159.
- Wolf, S. Foot motion in children shoes: a comparison of barefoot walking with shod walking in conventional and flexible shoes. Foot Ankle Surg. 2008;14(4):180-9. Epub 2008 Jul 7.
- Walther M. Children sport shoes–a systematic review of current literature. Department of Foot and Ankle Surgery, Orthopaedic Hospital Munich-Harlaching, Munich, Germany. Paediatr Child Health. 2009 Feb;14(2):121-2.
- Udaya Bhaskara Rao and Benjamin Joseph. The Influence of Footwear on the Prevalence of Flat Foot The Journal of Bone and Joint Surgery, 74B(4), 1992, pp. 525-527.
- Pfeiffer M, et al: Prevalence of flatfoot in preschool-aged children: Pediatrics, 2006
- Dowling AM, et al: Does obesity Influence foot structure and plantar pressure patterns in prepubescent children?: Int J Obes Relat Metab Disord, 2001
- Mickle KJ, et al: Does excess mass affect plantar pressures in young children?: Int J Pediatr Obes, 2006
- Mickle KJ, et al: The feet of overweight and obese young children: Are they flat or fat?: Obesity, 2006
- Selby-Silverstein, et al: The effect of foot orthoses on standing foot posture and gait of young children with Down’s Syndrome. Neurorehab, 2001.
- Evans. AM: The flatfooted child—To treat or not to treat. JAPMA, 2008.